Key Takeaways

Avoiding heat is one way to prevent worsening of MS symptoms such as fatigue.

Using an assistive device can help compensate for muscle weakness or balance problems.

Depression can be a symptom of MS or a consequence of being diagnosed with it.

The symptoms of multiple sclerosis (MS) are caused by the underlying disease in which an autoimmune process destroys parts of the myelin sheath that covers nerve fibers, leaving areas of scar tissue that disrupt the communication between the brain and other parts of the body.

Symptoms of MS vary widely from person to person, depending on which areas of the brain are affected.

Certain symptoms, however, are relatively common, including the following:

Fatigue One of the most common complaints of people living with multiple sclerosis is fatigue. MS-based fatigue can have multiple causes, so fighting fatigue often requires multiple approaches. Among those that may help are rest, avoiding heat, following a healthy diet and exercise program, treating depression (if you’re depressed), finding ways to manage stress, and working with your healthcare providers to find an MS treatment regimen that is effective for you.

Difficulty walking Multiple sclerosis can attack the part of the brain that regulates motor function. This problem is what Rick Sommers, diagnosed with MS in 1994 at age 34, calls "a predisposition to being clumsy" — meaning that it causes frequent stumbles and missteps. Many people with MS eventually need to use an assistive device such as a cane, walker, electric scooter, or wheelchair to stay mobile. Working with a physical therapist on strengthening and balance exercises can also be helpful.

Bladder or bowel dysfunctionBladder problems affect as many as 80 percent of people living with MS, according to the National Multiple Sclerosis Society (NMSS). Problems can include urgency, or a feeling of needing to urinate immediately; incontinence, or an involuntary loss of urine; and bladder retention, in which the bladder never empties completely. The most common form of bowel dysfunction among people with MS is constipation, although bowel incontinence can also occur.

Cognitive problemsHaving trouble processing thoughts, concentrating, remembering, or performing other tasks that require mental awareness or judgment is widespread among people with MS. Jeffrey Gingold, who was diagnosed in 1996 at age 36, suffers from cognitive issues as a result of MS. "Because it's a mental condition," Gingold says, "there's more of a stigma attached. People are reluctant to talk about it." Still, Gingold believes this perception is gradually changing. In the past, he says, "even healthcare providers sometimes had a tendency to write such issues off as stress, or a menopause-related problem for women." Now, he says, people are taking the common cognitive symptoms of multiple sclerosis more seriously.

Dizziness or vertigo Feeling dizzy, lightheaded, or off balance is common among people with MS. These feelings may be related to visual problems, to damage to the pathways connecting the brain and the inner ear, or to changes in sensation that limit the information the brain receives about the body’s position in space. Vertigo, in which one’s surroundings seem to be spinning, is less common and can also have a number of causes.

DepressionDepression can be caused by a number of factors in people with MS. For example, the shock of being diagnosed with a chronic illness can lead to depression in some people, and some of the medications used to slow the progression of MS can make symptoms of depression worse. Depression can also develop as a direct result of MS, occurring when the part of the brain that regulates emotions is attacked.

Sexual dysfunction MS can cause or contribute to various forms of sexual dysfunction, including difficulty having or maintaining an erection for men, and reduced vaginal lubrication, hypersensitivity, or reduced sensitivity for women. It can cause diminished libido in both sexes. MS-related sexual problems can result from the effect of the disease on the part of the brain that controls sexual function, or the nerves that send impulses to the sex organs. They can also result from such MS complications as pain, depression, fatigue, embarrassment over bladder or bowel problems, or a negative self-image.

Speech problemsSpeech issues can arise if the disease attacks the part of the brain that controls verbal communication or the nerves that send communication between the mouth and brain. Speech problems take the form of slurred or nasal-sounding speech and changes in cadence, such as pauses between words and syllables where none are usually found. Working with a speech language pathologist can often help.

Shortness of breath If multiple sclerosis damages the parts of the brain or spine that control lung function, breathing problems can result. They can also result from weakness, muscle stiffness, or sleep apnea associated with MS. Let your healthcare provider know if you’re feeling short of breath.